Secrets of a Successful Exploratory Laparotomy

Classic plication of the jejunum in a 3-year-old cat who ate a linear foreign body.

A great modern philosopher (her name is Patty Khuly, VMD) wrote about her concerns when dealing with some laparotomy cases ( "Surgery Peek and Shriek: My Worse Nightmare," November 2007). Some procedures are technical or specialized, but with any laparotomy, there are a few secrets worth sharing.

Three critical steps of an exploratory laparotomy include the amount of hair clipped, the length of the incision and how systematic you are.

The surgical site must be clipped adequately to allow a sufficient skin incision. This means that hair is generously clipped from cranial to the xiphoid region to the pubis. Laterally, the area extends to the inguinal folds.

Very few clients will object to that once they understand it is in the pet’s best interest— and that incisions heal side to side, not end to end. Therefore, a 10-inch incision heals at the same rate as a one-inch incision.

A celiotomy starts with a ventral midline skin incision, which must be long enough to access and visualize every abdominal organ from the liver to the bladder. In cats and female dogs, an incision from the xiphoid process to the pubis is recommended. This is one of the few cases where saying “Big surgeons make big incisions” is OK.

After dissecting the subcutaneous tissue, the linea alba is tented and incised carefully with a scalpel blade. The dorsal aspect of the linea is palpated, cra...